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Perkins JM, Nyakato V, Kakuhikire B, Sriken J, Schember CO, Baguma C, Namara EB, Ahereza P, Ninsiima I, Comfort AB, Audet CM, Tsai AC. Misperception of Norms About Intimate Partner Violence as a Driver of Personal IPV Attitudes and Perpetration: A Population-Based Study of Men in Rural Uganda. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241254143. [PMID: 38842209 DOI: 10.1177/08862605241254143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Intimate partner violence (IPV) against women is a global public health problem. Conceptual frameworks suggest misperceived norms around IPV might drive perpetration of violence against women in southern and eastern Africa. We conducted a cross-sectional, population-based survey of all men residing in a rural parish in southwest Uganda, eliciting their endorsement of IPV in five hypothetical scenarios and their reported frequency of perpetration of violence against their wife/main partner. They also reported their perceptions about the extent to which most other men in their villages endorsed and/or perpetrated IPV, which we compared against the population data to measure the primary explanatory variable of interest: whether individuals misperceived norms around IPV. We fitted multivariable Poisson regression models specifying personal IPV endorsement and IPV perpetration as the outcomes. Overall, 765 men participated in the study (90% response rate): 182 (24%) personally endorsed IPV, and 78 of 456 partnered men (17%) reported perpetrating one or more acts of IPV at least once per month. Although most men neither endorsed nor reported perpetrating IPV, 342 (45%) men mistakenly thought that most other men in their villages endorsed IPV and 365 (48%) men mistakenly thought that most other men perpetrate IPV at least monthly. In multivariable regression models, men who misperceived most men to endorse IPV were more likely to endorse IPV themselves (adjusted relative risk [aRR] = 2.44; 95% CI [1.66, 3.59]; p < .001). Among partnered men, those who misperceived IPV perpetration to be normative were more likely to perpetrate IPV themselves (aRR = 4.38; [2.53, 7.59]; p < .001). Interventions to correct misperceived norms about IPV may be a promising method for reducing violence against women in rural Uganda.
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Affiliation(s)
- Jessica M Perkins
- Vanderbilt University, Nashville, TN, USA
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Viola Nyakato
- Mbarara University of Science & Technology, Mbarara, Uganda
| | | | | | | | - Charles Baguma
- Mbarara University of Science & Technology, Mbarara, Uganda
| | | | | | | | | | | | - Alexander C Tsai
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Clark CJ, Ferguson G, Subedi S, Lad A, Hadd AR, Shrestha B, Shervinskie A, Tomar S, Baker H. Social norms, diffusion, and women's risk of intimate partner violence in Nepal: Impact assessment of a social and behavior Change communication intervention (Change Starts at home). SSM Popul Health 2024; 25:101583. [PMID: 38222673 PMCID: PMC10787293 DOI: 10.1016/j.ssmph.2023.101583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/17/2023] [Accepted: 12/09/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction Intimate partner violence (IPV) is a significant public health, human rights, and development issue. While existing evidence posits that addressing social norms is key to IPV prevention, successful IPV interventions that include a norms approach are limited in number and methodological rigor and rarely include a formal investigation of the diffusion of intervention impact. We contribute novel findings to this intellectual and programmatic space with evidence on a social and behavior change communication (SBCC) intervention (Change Starts at Home) in Nepal designed to prevent IPV and shift social norms towards greater gender equity. Methods Participants included 442 married women across 13 communities assessed at three timepoints: before intervention (baseline), at the completion of the core couple's curriculum and edutainment (midline), and at the conclusion of the diffusion curriculum (endline). Generalized estimating equations with propensity-score adjustments were used to determine change in outcomes at midline and endline for two intervention conditions (direct beneficiary, N = 173; and resident of the intervention community, (N = 178) relative to control (N = 91). Results IPV victimization significantly decreased in both intervention conditions at midline, with larger reductions in direct beneficiaries. At endline, direct beneficiaries had sustained reduction in IPV relative to control participants. Positive injunctive norms also significantly improved by midline for both intervention groups, whereas improvements in descriptive norms for intervention groups were matched by improvements in the control group at both midline and endline. Several secondary outcomes showed significant improvements for both intervention groups at midline and/or endline, including in-law violence, financial decision-making, communication, and relationship quality, with additional improvements for the direct beneficiaries in attitudes, leadership, GBV advocacy, and diffusion. Conclusion This study sheds light on the effectiveness of the Change intervention, the role of addressing social norms in IPV prevention efforts, and the benefits of organized diffusion.
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Affiliation(s)
- Cari Jo Clark
- Rollins School of Public Health, Emory University, 1518 Clifton Road NE, R Randall Rollins Building 628, Atlanta, GA, USA
| | | | | | - Arti Lad
- Equal Access International, Washington DC, USA
| | | | - Binita Shrestha
- Country Representative, Equal Access International, Kathmandu, Nepal
| | | | - Shweta Tomar
- Center on Gender Equity and Health, University of California San Diego, CA, USA
| | - Holly Baker
- Center on Gender Equity and Health, School of Public Health, University of California, San Diego, USA
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Meiksin R, Ponsford R, Kyegombe N, Kohli A, Bonell C. Assessing Survey Items on Social Norms Relating to Dating and Relationship Violence and to Gender: Cognitive Interviews with Young People in England. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1206-1227. [PMID: 37864423 PMCID: PMC10858622 DOI: 10.1177/08862605231204561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
Widespread among adolescents in England, dating and relationship violence (DRV) is associated with subsequent injuries and serious mental health problems. While DRV prevention interventions often aim to shift harmful social norms, no established measures exist to assess relevant norms and their role in mediating DRV outcomes. We conducted cognitive interviews exploring the understandability and answerability of candidate measures of social norms relating to DRV and gender roles, informing measure refinement. In all, 11 participants aged 13 to 15 from one school in England participated. Cognitive interviews tested two items assessing descriptive norms (beliefs about what behaviors are typical), three assessing injunctive norms (beliefs about what is socially acceptable), and (for comparison) one assessing personal attitudes. Findings were summarized by drawing on interview notes. Summaries and interview notes were subjected to thematic analysis. For some participants, injunctive norms items required further explanation to clarify that items asked about others' views, not their own. Lack of certainty about, and perceived heterogeneity of, behaviors and views among a broad reference group detracted from answerability. Participants were better able to answer items for which they could draw on concrete experiences of observing or discussing relevant behaviors or social sanctions. Data suggest that a narrowed reference group could improve answerability for items assessing salient norms. Findings informed refinements to social norms measures. It is possible to develop social norms measures that are understandable and answerable for adolescents in England. Measures should assess norms that are salient and publicly manifest among a cohesive and influential reference group.
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Affiliation(s)
| | - Ruth Ponsford
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Chris Bonell
- London School of Hygiene & Tropical Medicine, London, UK
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Meiksin R, Bonell C, Bhatia A, Melendez-Torres G, Kyegombe N, Kohli A. Social Norms About Dating and Relationship Violence and Gender Among Adolescents: Systematic Review of Measures Used in Dating and Relationship Violence Research. TRAUMA, VIOLENCE & ABUSE 2024; 25:448-462. [PMID: 36825788 PMCID: PMC10666486 DOI: 10.1177/15248380231155526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Adolescent dating and relationship violence (DRV) is widespread and associated with increased risk of subsequent poor mental health outcomes and partner violence. Shifting social norms (i.e., descriptive norms of perceived behavior and injunctive norms of acceptable behavior among a reference group of important others) may be important for reducing DRV. However, few DRV studies assess norms, measurement varies, and evidence on measure quality is diffuse. We aimed to map and assess how studies examining DRV measured social norms concerning DRV and gender. We conducted a systematic review of DRV literature reporting on the use and validity of such measures among participants aged 10-18 years. Searches included English peer-reviewed and grey literature identified via nine databases; Google Scholar; organization websites; reference checking; known studies; and expert requests. We identified 24 eligible studies from the Americas (N = 15), Africa (N = 4), and Europe (N = 5) using 40 eligible measures of DRV norms (descriptive: N = 19; injunctive: N = 14) and gender norms (descriptive: N = 1; injunctive: N = 6). No measure was shared across studies. Most measures were significantly associated with DRV outcomes and most had a defined reference group. Other evidence of quality was mixed. DRV norms measures sometimes specified heterosexual relationships but rarely separated norms governing DRV perpetrated by girls and boys. None specified sexual-minority relationships. Gender norms measures tended to focus on violence, but missed broader gendered expectations underpinning DRV. Future research should develop valid, reliable DRV norms and gender norms measures, and assess whether interventions' impact on norms mediates impact on DRV.
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Affiliation(s)
| | - Chris Bonell
- London School of Hygiene & Tropical Medicine, UK
| | - Amiya Bhatia
- London School of Hygiene & Tropical Medicine, UK
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Garcia-Vergara E, Almeda N, Fernández-Navarro F, Becerra-Alonso D. Artificial intelligence extracts key insights from legal documents to predict intimate partner femicide. Sci Rep 2023; 13:18212. [PMID: 37875522 PMCID: PMC10598201 DOI: 10.1038/s41598-023-45157-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 10/17/2023] [Indexed: 10/26/2023] Open
Abstract
Legal documents serve as valuable repositories of information pertaining to crimes, encompassing not only legal aspects but also relevant details about criminal behaviors. To date and the best of our knowledge, no studies in the field examine legal documents for crime understanding using an Artificial Intelligence (AI) approach. The present study aims to fill this research gap by identifying relevant information available in legal documents for crime prediction using Artificial Intelligence (AI). This innovative approach will be applied to the specific crime of Intimate Partner Femicide (IPF). A total of 491 legal documents related to lethal and non-lethal violence by male-to-female intimate partners were extracted from the Vlex legal database. The information included in these documents was analyzed using AI algorithms belonging to Bayesian, functions-based, instance-based, tree-based, and rule-based classifiers. The findings demonstrate that specific information from legal documents, such as past criminal behaviors, imposed sanctions, characteristics of violence severity and frequency, as well as the environment and situation in which this crime occurs, enable the correct detection of more than three-quarters of both lethal and non-lethal violence within male-to-female intimate partner relationships. The obtained knowledge is crucial for professionals who have access to legal documents, as it can help identify high-risk IPF cases and shape strategies for preventing crime. While this study focuses on IPF, this innovative approach has the potential to be extended to other types of crimes, making it applicable and beneficial in a broader context.
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Affiliation(s)
| | - Nerea Almeda
- Department of Psychology, Universidad Loyola Andalucía, Sevilla, Spain
| | | | - David Becerra-Alonso
- Department of Quantitative Methods, Universidad Loyola Andalucía, Sevilla, Spain
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Richardson RA, Hadd AR, Rodriguez-Planas N, Wiederkehr K, Jamshed F, Benmarhnia T, Clark CJ. Does domestic violence legislation reduce permissive attitudes about intimate partner violence? Longitudinal evidence from men and women from 61 countries. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.23.23297413. [PMID: 37961711 PMCID: PMC10635179 DOI: 10.1101/2023.10.23.23297413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background Intimate partner violence (IPV) is highly prevalent and has substantial implications for women's health. Changing IPV attitudes is one pathway to reduce IPV. While evidence suggests that interventions targeting individuals may change IPV attitudes, the effect of wider-scale interventions, such as legislation, remain unknown. Methods We used individual-level IPV attitudes information collected between 1997 and 2020 by the Demographic and Health Surveys (DHS) and the Multiple Indicator Cluster Surveys (MICS), which we linked with national-level domestic violence (DV) legislation information. We evaluated the effect of adoption of DV legislation on changes in IPV attitudes using a difference-in-differences study design that controlled for time-varying country-level confounding and accounted for staggered timing of legislation adoption. Findings Our sample included 2,184,047 women from 60 countries and 390,877 men from 40 countries. After controlling for country-level confounders, adoption of DV legislation reduced IPV acceptability among women (average treatment effect among treated (ATT) = -0.07, 95% CI: -0.16, 0.06) and men (ATT = -0.11, 95% CI: -0.22, 0.03) although estimates were imprecise and included the null. Interpretation DV legislation may reduce permissive IPV attitudes, especially among men, although conclusions should be interpreted cautiously due to imprecise estimates. Funding Eunice Kennedy Shriver National Institute of Child Health and Human Development (5R00HD104896).
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Affiliation(s)
- Robin A Richardson
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Alexandria R Hadd
- Department of Epidemiology, Rollins School of Public Health, Emory University
- Hubert Department of Global Health, Rollins School of Public Health, Emory University
| | | | - Katjana Wiederkehr
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Farheen Jamshed
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California San Diego
| | - Cari Jo Clark
- Hubert Department of Global Health, Rollins School of Public Health, Emory University
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Kuchukhidze S, Panagiotoglou D, Boily MC, Diabaté S, Imai-Eaton JW, Stöckl H, Mbofana F, Wanyenze RK, Maheu-Giroux M. Characteristics of male perpetrators of intimate partner violence and implications for women's HIV status: A pooled analysis of cohabiting couples from 27 countries in Africa (2000-2020). PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002146. [PMID: 37672520 PMCID: PMC10482294 DOI: 10.1371/journal.pgph.0002146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023]
Abstract
Intimate partner violence (IPV) may increase women's HIV acquisition risk. Still, knowledge on pathways through which IPV exacerbates HIV burden is emerging. We examined the individual and partnership-level characteristics of male perpetrators of physical and/or sexual IPV and considered their implications for women's HIV status. We pooled individual-level data from nationally representative, cross-sectional surveys in 27 countries in Africa (2000-2020) with information on past-year physical and/or sexual IPV and HIV serology among cohabiting couples (≥15 years). Current partners of women experiencing past-year IPV were assumed to be IPV perpetrators. We used Poisson regression, based on Generalized Estimating Equations, to estimate prevalence ratios (PR) for male partner and partnership-level factors associated with perpetration of IPV, and men's HIV status. We used marginal standardization to estimate the adjusted risk differences (aRD) quantifying the incremental effect of IPV on women's risk of living with HIV, beyond the risk from their partners' HIV status. Models were adjusted for survey fixed effects and potential confounders. In the 48 surveys available from 27 countries (N = 111,659 couples), one-fifth of women reported that their partner had perpetrated IPV in the past year. Men who perpetrated IPV were more likely to be living with HIV (aPR = 1.09; 95%CI: 1.01-1.16). The aRD for living with HIV among women aged 15-24 whose partners were HIV seropositive and perpetrated past-year IPV was 30% (95%CI: 26%-35%), compared to women whose partners were HIV seronegative and did not perpetrate IPV. Compared to the same group, aRD among women whose partner was HIV seropositive without perpetrating IPV was 27% (95%CI: 23%-30%). Men who perpetrated IPV are more likely to be living with HIV. IPV is associated with a slight increase in young women's risk of living with HIV beyond the risk of having an HIV seropositive partner, which suggests the mutually reinforcing effects of HIV/IPV.
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Affiliation(s)
- Salome Kuchukhidze
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - Dimitra Panagiotoglou
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - Marie-Claude Boily
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Souleymane Diabaté
- Département de Médecine Sociale et Préventive, Université Laval, Québec, QC, Canada
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Département de Médecine et Spécialités Médicales, Université Alassane Ouattara, Bouaké, Côte d’Ivoire
| | - Jeffrey W. Imai-Eaton
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
- Center for Infectious Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Heidi Stöckl
- Institute for Medical Information Processing, Biometry, and Epidemiology, Medical Faculty, LMU Munich, Munich, Germany
| | | | - Rhoda K. Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada
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Phiri M, Namayawa S, Sianyeuka B, Sikanyiti P, Lemba M. Determinants of spousal physical violence against women in Zambia: a multilevel analysis. BMC Public Health 2023; 23:934. [PMID: 37221522 DOI: 10.1186/s12889-023-15927-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/18/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Violence against women and girls is a major public health issue, a violation of human rights, and is linked to a number of harmful effects on one's physical, mental, sexual, and reproductive health. Studies conducted in other parts of sub-Saharan Africa (SSA) suggest that there is an association between contextual factors and experience of intimate partner violence. However, in Zambia, this association is not well documented. Thus, this study was conducted to examine how individual and community-level characteristics influence spousal violence against women in Zambia. METHODS Data from the most recent Zambia Demographic and Health Survey conducted in 2018 was used. A sample of 7,358 ever-married women aged 15-49 years was used in the analysis. Two level multilevel binary logistic regression models were employed to examine the association between individual and contextual-level factors and experience of spousal violence. RESULTS The prevalence of spousal physical violence against women in Zambia was 21.1% [95% CI, 19.8, 22.5]. Women aged 15-19 [aOR = 2.36, 95% CI = 1.34-4.14] and 20-24 [aOR = 2.11, 95% CI = 1.38-3.22], who did not own mobile phone [aOR = 1.36, 95% CI = 1.10-1.69], and had low decision making autonomy [aOR = 1.24, 95% CI = 1.01-1.54] were more likely experience spousal physical violence. Furthermore, communities which had a low proportion of women with decision making power [aOR = 1.66, 95% CI = 1.26-2.19] were more likely experience spousal physical violence. Additionally, women whose partners' drank alcohol [aOR = 2.81, 95% CI = 2.30-3.45] and those whose partners exhibited jealous behaviour [aOR = 2.38, 95% CI = 1.88-3.21] were more likely to experience spousal physical violence. CONCLUSION Both individual and community-level factors influenced spousal physical violence in Zambia. Integrating community level factors when designing interventions to address gender-based would be key to reduce women's vulnerability to gender based violence in the country. There is need to re-evaluate and re-strategize current strategies being implemented to address gender based violence in the country to make them context specific.
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Affiliation(s)
- Million Phiri
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Sibongile Namayawa
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | | | | | - Musonda Lemba
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
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